If nothing else, it gives you good info about what goes into each panel, gives info on cost, response time, why IPS is more sought after, etc...From the above link ( IPS panels typically offer much better color reproduction and much wider viewing angles.....................)

I need to find dual paired 23" or 27" medical grade monitors and graphics cards to enable us to get to either (1920x1200) or (2560x1440) respectively.

Medical grade means compliant with the DICOM standard. I would suggest EIZO products, if you can afford them. Have a look at their site http://www.eizo.com/global/solutions/medical/index.html. They have 3MP and 5MP monitors in various sizes with 10bit color and DICOM validation. We use cheaper 22" inch models for everyday work. You could get away with decent IPS panels (say, HP ZR2440), but then you wouldn't be asking about medical grade... I imagine any decent graphics card will do.

EDIT: if you want 10-bit color, you need professional grade graphics card, not necessarily expensive. A $130 FireGL will do...

It seems to be more about a data format for the interchange of medical imaging data. I do see that Eizo is pimping that their RadiForce line is adjusted at the factory to have those brightness characteristics and it has software that helps, but I don't know that it will be of help to the OP since he's running some closed system (?) and the software is probably Windows-based.

So basically the characteristic you want for a "medical" monitor is to brighten the dark areas. The OP's old monitor doesn't seem to conform to that standard/washing out feature nor do the two that were recommended. And hell, they got a ton of things they adhere to:

I submit that the OP didn't know what "medical grade" really meant. Which is fine, I mean, I didn't know until you just posted and it's been an interesting learning experience. Medical places get sold on high pixel count and washed out blacks which makes sense, it's just funny that you pay a premium for that kinda stuff.

Maybe all that DICOM human contrast sensitivity talk is to prevent patients from having seizures when looking the computer monitor in the room? I can't help but to wonder if this "requirement" could be met using any old monitor and a calibrator.

Scrotos wrote:So basically the characteristic you want for a "medical" monitor is to brighten the dark areas. The OP's old monitor doesn't seem to conform to that standard/washing out feature nor do the two that were recommended. And hell, they got a ton of things they adhere to:

Actually, the display has to follow precisely the luminance curve so that (a) the distinction between shades of grey is as easy as possible, (b) the difference between say gray #200 and #205 is the same as #50 and #55 and (c) two different monitors on different PCs will show the exact same image. That last part is very important because you want the same data to give the same image on every PC at every possible time (imagine someone comes for follow-up exam after 5 years and you have changed equipment). If you are a photographer it is usually simpler, because you only need to calibrate YOUR camera with YOUR panel and YOUR printer, while medical standards compliance means that everyone is calibrated to show more or less the same.

Now, I'm not going to argue that you become a better doctor by using a $5000 panel, but if you want validation for your workflow, you should consider applying the standards. Finally, to put these into perspective, a PET/CT exam is billed something like $2000 and an angiography procedure may be >$5000. A hospital will do several per day. The machine (MRI for example) these monitors are connected to is usually seven figures...

In case anyone's wondering about where I'm getting the "make the darks brighter" bit from:

The human eye is relatively less sensitive in the dark areas of an image than it is in the bright areas of an image. This variation in sensitivity makes it much easier to see small relative changes in Luminance in the bright areas of the image than in the dark areas of the image. A Display Function that adjusts the brightness such that equal changes in P-Values will result in the same level of perceptibility at all driving levels is “perceptually linearized”. The Grayscale Standard Display Function incorporates the notion of perceptual linearization without making it an explicit objective of PS 3.14.

It does make sense to me. You'd think there would be some brightness profiles you could select like "color temperature" that some monitors offer. Then you could dual-sell your monitor line for consumer and medical. Perhaps that's enough of a niche market that no one would care to make the effort, though.

The human eye is relatively less sensitive in the dark areas of an image than it is in the bright areas of an image. This variation in sensitivity makes it much easier to see small relative changes in Luminance in the bright areas of the image than in the dark areas of the image. A Display Function that adjusts the brightness such that equal changes in P-Values will result in the same level of perceptibility at all driving levels is “perceptually linearized”. The Grayscale Standard Display Function incorporates the notion of perceptual linearization without making it an explicit objective of PS 3.14.

All monitors do that by applying gamma correction. If I understand correctly, the DICOM uses a different equation. Anyway, as you say, they probably add an extra mode plus some QC to justify the price tag...

The application is Oncological Radiology and DICOM is the standard used for reading the image data but doesn't come into play when displaying images to the monitor. Thank you for the links to EIZO - I will see if anything of that caliber is within our budget and check with our vendor whether it would work with our existing LINUX systems.

Are there any Radiologists or anyone supporting said medical personnel as contributors that can offer their recommendation of what reading equipment they employ?

The Dome E3 and Dome E2 are likely the most 'affordable' of the bunch.

Also, I have previously purchased a used medical imaging (DICOM certified) display on Ebay - it worked perfectly for our development needs. You'll find good prices on used (perhaps 5-6 year old) models on Ebay.

Eizo and NEC Displays are also widely used in the medical imaging industry. Grayscale displays are much more expensive than 'off-the-shelf' color displays for all of the reasons that have already been posted here earlier. Calibration-software is a key part of the 'display product' that these companies sell.

jazzstr8ahead wrote:The application is Oncological Radiology and DICOM is the standard used for reading the image data but doesn't come into play when displaying images to the monitor. Thank you for the links to EIZO - I will see if anything of that caliber is within our budget and check with our vendor whether it would work with our existing LINUX systems.

I am a medical oncologist myself (not a radiologist). Anyway, you can find a cheaper solution if you are willing to buy decent IPS monitors AND a calibration tool. I wouldn't personally go for AdobeRGB (you don't need wide gamut), but rather plain sRGB coverage (8-bit!) with good greyscale and excellent uniformity. Something like the HP ZR2740w would make a good panel if you can calibrate it. Dell U2713 should also be a good choice. Both should be around the $700 mark. I use the HP ZR24w at home and it compares favorably with the EIZOs we have at the hospital. Some friend radiologists even prefer Apple computers at work, so any panel that is not worse than the Apple Cinema displays cannot be bad.

I imagine you can even do DICOM calibration if you can find the software, although the result would not be "validated". Not that it matters that much.

ptsant wrote:If you are a photographer it is usually simpler, because you only need to calibrate YOUR camera with YOUR panel and YOUR printer, while medical standards compliance means that everyone is calibrated to show more or less the same.

This is off on a tangent, but I thought I'd point out that this isn't really how it works. If you calibrated devices to each other, you'd end up with problems as a device's color characteristics shift over time. Take into account each device shifting differently over that same time frame, and a small workflow quite likely having a scanner, multiple monitors, a camera, and a printer, and you have some serious problems. Then what happens when you replace a device? How about sending out an image for printing?

What you're actually doing is calibrating each device to a single theoretical color space, usually L*, a*, b* which is based on actual human vision. When you scan something or import a photograph, the colors are being adjusted one way or another to that central color space. The display drivers and printer drivers/RIP then use their own calibration to adjust the colors suitably. So if you're calibrating properly, everyone who calibrates properly should see and print your images more or less the same, just like medical standards. Well, not just like, but the end result is more or less the same.

Obviously if someone has a well calibrated $100 TN monitor, they won't be able to see as much of the gamut as you can on your $1500 Eizo or NEC monitor. Likewise, your prints on a laser or cheap inkjet, or press with poor quality inks won't represent as full a gamut, no matter how accurate due to calibration, as a 12 color Epson inkjet, or a press run by an operator with high quality control standards, quality inks and paper, and good knowledge of a densitometer.

I was told that, together with the GPU, it was about 3 grand. However, we always sacrifice cost savings and just buy exactly what the vendor tells us to. Not my preferred method, but in the medical field, saving 2 grand every 5 years doesn't mean a whole lot.

I would like to point out however, that none of the 3 Viewsonic monitors in the OP are DICOM certified including the monitors they're currently using. (at least not that I can find) When asked, Viewsonic just pointed jazzstr8ahead to a couple of their IPS displays. Are we overanalyzing this?

I was mainly interested in learning more about what "medical grade" entails and why the OP would specify that when the original monitors looked normal and the ones he was recommended looked normal, too.

However, I think we need to look into the video card(s). I don't think they support the resolution the OP wants in a 27" monitor. A Sun box running Linux? Is there any additional information on the reading stations and what type of expandability is available?

Otherwise just go with a 1920x1200 display. Smaller but at least they'd work.

Honestly, this is one of the few times I'd agree with our wanton spending due to vendor recommendations. One missed fracture could easily make up the difference you save in a monitor. I'd only go the more inexpensive route if you have absolutely no other choice.

One more thing about "medical grade" is that it's supposed to have intentionally crappy off-angle viewing, enabled using some sort of 'privacy filter' on the monitor.It's to prevent people from reading the monitor while looking over your shoulder, because confidentiality of patient info and stuff.

More info should be readily available by searching for HIPAA guidelines.

Not necessarily; in the dark caves where radiologists dwell, privacy doesn't matter (since they are often alone, or not there but at the coffee table).*Privacy filters are mightily anoying when you are looking together to see what that thing exactly is.² Most of the times, you want something like that on the registration desks, but the moment you are in a room with the actual patients, or in an office/ward centre, you want to see your pictures nice and clear from any angle.

Given the average wage of a radiologist, I'd go for the professional and certified option.

* or working at home, or sleeping at home and looking at the pictures you needed at 2am around 9am² if you see a thing, the problem is usually easy to solve. It gets more difficult when there "should" be something, but isn't. Or may be but perhaps not. Medicine is unfortunately not black and white, but a 1000 shades of gray.³³ the barco supports 1024 shades